Abstract
Measurement of hospital quality has traditionally focused on processes of care and postprocedure outcomes. Appropriateness measures for percutaneous coronary intervention (PCI) assess quality as it relates to patient selection and the decision to perform PCI. The association between patient selection for PCI and processes of care and postprocedural outcomes is unknown. We included 203 531 patients undergoing nonacute (elective) PCI from 779 hospitals participating in the National Cardiovascular Data Registry (NCDR) CathPCI Registry between July 2009 and April 2011. We examined the association between a hospital's proportion of nonacute PCIs categorized as inappropriate by the 2009 Appropriate Use Criteria (AUC) for Coronary Revascularization and in-hospital mortality, bleeding complications, and use of optimal guideline-directed medical therapy at discharge (ie, aspirin, thienopyridines, and statins). When categorized as hospital tertiles, the range of inappropriate PCI was 0.0% to 8.1% in the lowest tertile, 8.1% to 15.2% in the middle tertile, and 15.2% to 58.6% in the highest tertile. Compared with lowest-tertile hospitals, mortality was not significantly different at middle-tertile (adjusted odds ratio [OR], 0.93; 95% confi...Continue Reading
References
Jun 19, 1998·The New England Journal of Medicine·R A Lange, L D Hillis
Jun 23, 2001·Journal of the American College of Cardiology·R G BrindisJ F Williams
Feb 18, 2003·JAMA : the Journal of the American Medical Association·A Michael LincoffUNKNOWN REPLACE-2 Investigators
Sep 5, 2006·The American Journal of Cardiology·Fulvio StaculUNKNOWN CIN Consensus Working Panel
Mar 28, 2007·The New England Journal of Medicine·William E BodenUNKNOWN COURAGE Trial Research Group
Aug 16, 2008·The New England Journal of Medicine·William S WeintraubG B J Mancini
Dec 17, 2008·American Heart Journal·Sanjit S JollyShamir R Mehta
Feb 5, 2009·Annals of Internal Medicine·Giancarlo MarenziAntonio L Bartorelli
Feb 7, 2009·Journal of the American College of Cardiology·Manesh R PatelUNKNOWN Society of Cardiovascular Computed Tomography
May 20, 2009·Circulation·Robert C HendelUNKNOWN Society of Nuclear Medicine
May 26, 2009·JACC. Cardiovascular Interventions·Sunil V RaoEric D Peterson
Jun 9, 2009·The New England Journal of Medicine·UNKNOWN BARI 2D Study GroupBurton E Sobel
Jul 7, 2009·The American Journal of Cardiology·William E BodenUNKNOWN COURAGE Trial Investigators
Dec 25, 2009·Circulation. Cardiovascular Interventions·Sameer K MehtaUNKNOWN National Cardiovascular Data Registry
Sep 1, 2008·Circulation. Cardiovascular Quality and Outcomes·William S WeintraubUNKNOWN Department of Veterans Affairs Cooperative Studies Program No. 424 (COURAGE Trial) Investigators and Study Coordinators
Jan 20, 2010·Journal of the American College of Cardiology·Elizabeth H BradleyHarlan M Krumholz
May 1, 2010·Journal of the American College of Cardiology·Eric D PetersonUNKNOWN NCDR Registry Participants
Jun 3, 2010·JAMA : the Journal of the American Medical Association·Steven P MarsoUNKNOWN National Cardiovascular Data Registry
Oct 27, 2010·Circulation·Allen J TaylorUNKNOWN Society for Cardiovascular Magnetic Resonance
Feb 23, 2011·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Pamela S DouglasRory B Weiner
Jul 7, 2011·JAMA : the Journal of the American Medical Association·Paul S ChanJohn A Spertus
Feb 2, 2012·Circulation·Paul FreyFrederic S Resnic
Feb 14, 2012·JACC. Cardiovascular Interventions·Steven P MarsoJ Aaron Grantham
May 10, 2012·Circulation. Cardiovascular Quality and Outcomes·Steven M BradleyChris L Bryson
Oct 1, 2012·Journal of the American Heart Association·Robert F RileyJ Richard Goss
Citations
Jun 4, 2014·The American Journal of Cardiology·Mouin S AbdallahPaul S Chan
Oct 5, 2014·BMC Cardiovascular Disorders·Harindra C WijeysunderaDennis T Ko
May 25, 2013·The American Journal of Emergency Medicine·Deborah B DiercksJames A de Lemos
Apr 15, 2015·Clinical Cardiology·David E WinchesterRebecca J Beyth
Sep 23, 2014·JACC. Cardiovascular Interventions·Olivia Y HungH Vernon Anderson
Mar 2, 2013·Journal of the American College of Cardiology·David R HolmesMichael J Mack
Sep 24, 2013·Journal of the American College of Cardiology·Karen E Joynt
Sep 18, 2015·PloS One·Michael P ThomasHitinder S Gurm
Apr 17, 2014·Circulation. Cardiovascular Interventions·David P Faxon
Mar 25, 2015·Circulation·Karen E Joynt
May 30, 2015·Circulation·Steven M BradleyCharles Maynard
May 30, 2015·Circulation·Gregory J Dehmer, Manesh R Patel
Jun 2, 2018·Circulation. Cardiovascular Quality and Outcomes·Daniel M AlyeshBrahmajee K Nallamothu
Feb 6, 2014·Circulation. Cardiovascular Interventions·Anjan K ChakrabartiC Michael Gibson
May 16, 2013·Circulation. Cardiovascular Quality and Outcomes·Manesh R Patel, Sunil V Rao
Oct 10, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Frederick G P WeltUNKNOWN Interventional Section Leadership Council, American College of Cardiology
Nov 12, 2019·Circulation. Cardiovascular Quality and Outcomes·Tharmegan TharmaratnamR Sacha Bhatia
Jul 28, 2019·Korean Circulation Journal·Dong Ho ShinKyoo Rok Han
Apr 22, 2020·JAMA Network Open·Paul L HessSteven M Bradley
Apr 10, 2013·PharmacoEconomics·Michael J SorichBrita Pekarsky
Mar 27, 2021·Circulation. Cardiovascular Imaging·Anirudh KumarPaul C Cremer
Jun 4, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Lloyd W KleinUNKNOWN AUC Workgroup of the ISLC Endorsed by the Interventional Section Leadership Council, American College of Cardiology